2Diagnosis of wound infection

Introduction

Early identification of a wound infection is the first step towards the prompt intensive treatment necessary for optimal results. Any wound communicating with a fracture, whether due to the injury, or created by a surgeon, is at risk of becoming infected.
Recognition of those factors that predispose to infection should increase the surgeon’s alertness to the possibility of infection. Early signs of infection are not specific and may easily be misinterpreted, as an inflammatory response is normally present in the region of a fracture, even without infection. Often, the first sign of wound infection is that the inflammation fails to resolve as quickly as expected. Certainly, increasing signs of inflammation (wound drainage, redness, swelling, pain and tenderness,
fever) must be regarded as indicators of likely infection.
If the surgeon is concerned about infection, all steps to diagnose, or exclude, this possibility must be taken, as a matter of urgency.